3rd Quarter Registration Form

3rd Quarter Convention Registration

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Registration *

Full Registration - Includes Art Auction, Friday Social and Saturday Outing. Best Deal! Semi-Full Registration - Includes Fri Social, Sat. banquet, EXCLUDES Sat afternoon outing OYV and Awards Banquet Sat. Afternoon Outing Name Tag Only Virginia Jaycee Training and Meetings Affiliate Meetings Only Friday Night Social Extra Banquet Ticket

Submit

**If paying through PayPal, please also complete and submit the information above or submit the registration form.